Multimodality Imaging for Right Ventricular Function Assessment in Severe Tricuspid Regurgitation

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Echocardiography

Background:

• Severe tricuspid regurgitation (TR) is linked to poor cardiovascular outcomes.
• Right ventricle (RV) dysfunction in TR patients significantly impacts prognosis and operative risks.
• Accurate RV function assessment is vital for patient selection and timing of interventions.

Purpose of the Study:

• To review and comprehensively assess various imaging techniques for evaluating RV function in the context of severe TR.
• To highlight the challenges in assessing RV function due to TR-induced hemodynamic changes.
• To emphasize the role of advanced imaging in identifying subtle RV dysfunction.

Main Methods:

• Review of current literature on echocardiography (including 3D and speckle tracking), cardiac magnetic resonance (CMR), and cardiac computed tomography (CCT).
• Discussion of the limitations of conventional echocardiographic indices in severe TR.
• Focus on the utility of specific techniques like RV-FWLS, 3D RV volumes, and CMR for precise RV assessment.

Main Results:

• Conventional echocardiography has limitations in evaluating RV function in severe TR.
• Advanced echocardiographic techniques (3D, RV-FWLS) show promise.
• Cardiac magnetic resonance (CMR) is the gold standard for RV volumes and ejection fraction, offering prognostic data.
• Cardiac computed tomography (CCT) aids in transcatheter interventions by measuring RV and annulus dimensions.

Conclusions:

• Accurate RV function assessment in severe TR is challenging but critical.
• Multimodality imaging approaches are often necessary to detect subtle RV dysfunction.
• Early identification of RV dysfunction guides the decision between medical management and timely intervention, improving patient outcomes.